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Laparoscopic pancreatectomy for solid pseudo-papillary tumors of the pancreas is a suitable technique; our experience with long-term follow-up and review of the literature.

AbstractBACKGROUND:
Solid pseudopapillary tumors (SPTs) are rare pancreatic neoplasms of low malignant potential that occur mainly in young women. Only 17 cases of SPT treated laparoscopically have been published in the literature and long-term follow-up data are still lacking.
METHODS:
Retrospective analysis of ten patients (8 women, 2 men; mean age, 25.4 years) (DS: 12.1; minimum 11, maximum 51) who underwent laparoscopic distal pancreatectomy with a definitive histological diagnosis of SPT. Long-term follow-up data were collected.
RESULTS:
The average tumor size was 43.8 mm (minimum 20, maximum 65 mm). The mean operative time was 177.5 minutes (DS: 53.7; minimum 120, maximum 255). In all, five patients underwent distal splenopancreatectomy; five patients underwent spleen-preserving distal pancreatectomy of whom three with splenic vessel preservation and two with the Warshaw technique. The conversion rate was nil and no case of perioperative mortality was recorded. The mean hospital stay was 7 days (DS: 2.7; minimum 4, maximum 12). Six patients had an uneventful postoperative course and four had postoperative complications. Two of them underwent reoperation, and the other two had nonsurgical complications. After a median follow-up of 47 (range, 5-98) months, all patients were alive and disease-free.
CONCLUSIONS:
Laparoscopic pancreatic resection is a safe and feasible procedure that could become the treatment of choice for patients affected by pancreatic SPT. Distal pancreatectomy should be performed, if possible, with spleen-preserving technique, especially in young patients. To avoid metastatic spread, laparoscopic or laparotomic biopsy should not be performed in patients affected by SPT.
AuthorsAlvise Cavallini, Cavallini Alvise, Giovanni Butturini, Butturini Giovanni, Despoina Daskalaki, Daskalaki Despoina, Roberto Salvia, Salvia Roberto, Gianluigi Melotti, Melotti Gianluigi, Micaela Piccoli, Piccoli Micaela, Claudio Bassi, Bassi Claudio, Paolo Pederzoli, Pederzoli Paolo
JournalAnnals of surgical oncology (Ann Surg Oncol) Vol. 18 Issue 2 Pg. 352-7 (Feb 2011) ISSN: 1534-4681 [Electronic] United States
PMID20848223 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Cystadenoma, Papillary (pathology, surgery)
  • Female
  • Follow-Up Studies
  • Humans
  • Laparoscopy
  • Male
  • Minimally Invasive Surgical Procedures
  • Neoplasm Recurrence, Local (pathology, surgery)
  • Pancreatic Neoplasms (pathology, surgery)
  • Prospective Studies
  • Retrospective Studies
  • Review Literature as Topic
  • Survival Rate
  • Treatment Outcome

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